What is the importance of preeclampsia?
Preeclampsia is the most common and important of the hypertensive disorders of pregnancy, affecting between 5% and 7% of pregnancies.
Preeclampsia is a multisystem disease. The American College of Obstetrics and Gynecology does not require proteinuria if other end-organ disease is present. Severe preeclampsia is denoted by its most common symptoms, microangiopathic Hemolytic anemia, Elevated Liver enzymes and Low Platelets (HELLP syndrome). It can be accompanied by severe manifestations including acute kidney injury, stroke, blindness from vasoconstriction in the occipital lobe or retinal detachment, disseminated intravascular coagulation, hepatic rupture, or pulmonary edema.
Preeclampsia may progress to seizures, a progression that changes the designation to eclampsia. The hypertension in preeclampsia is identified relative to prepregnancy blood pressure.
A rise in systolic blood pressure of 30 mm Hg or a rise in diastolic blood pressure of 15 mm Hg raises the possibility of preeclampsia. The definitive treatment of preeclampsia is delivery of the baby and placenta, but depending on the severity of the preeclampsia, efforts may be made to postpone delivery if it occurs in the second trimester or early in the third trimester. Anticonvulsants, most commonly magnesium in the U.S., and antihypertensive drugs are usually required while getting the mother ready for delivery.
Over the last decade, long-term follow-up of large populations of women with preeclampsia has shown a subsequent increased risk of cardiovascular disease, kidney biopsy, and end-stage kidney disease (ESKD).
